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Author: Richard Klaghofer (79)


Mar
2018

Deep sedation using propofol has become a standard technique in children. This double-blinded randomized clinical trial aims to compare the clinical effects of propofol-mono-sedation vs a combination of propofol and ketamine at induction and a reduced propofol infusion rate for maintenance in children undergoing diagnostic magnetic resonance imaging.
Children aged from 3 months to 10 years scheduled as outpatients for elective magnetic resonance imaging with deep sedation were included.

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Aug
2017

Repetitive skin manipulation is the key symptom in skin picking disorder (SPD) or acne excoriée des jeunes filles Brocq. The diagnostic and statistical manual of mental disorders (DSM-5) has recognized SPD as an independent disease, namely an obsessive-compulsive disorder. Thus, psychiatric treatment is indicated.

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Dec
1969

Delirium has been recognised as an underdiagnosed and undermanaged syndrome with substantial prevalence rates and potentially deleterious consequences in the medically ill population. Despite its frequent administration in the management of delirium, the effectiveness of pipamperone has not yet been evaluated.
In this retrospective, descriptive cohort study of 192 patients, pipamperone as monotherapy and as an adjunct to haloperidol, haloperidol alone, or atypical antipsychotics were compared with respect to their effectiveness in the management of delirium and its subtypes over the course of 20 days.

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May
2017

Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established.

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Dec
1969

Many patients suffering from trichotillomania (TTM) have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated) remain largely unknown.

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Dec
2016

Emergency situations and conditions with impaired gastric emptying enhance the risk of perioperative pulmonary aspiration due to increased residual gastric contents volume (GCV). Gastric ultrasonographic (US) measurement of the gastric antral cross-sectional area (CSA) has been proposed to estimate preanesthetic GCV. However, only few healthy children and fasted pediatric patients have been investigated so far, predicting GCV with considerable imprecision.

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Dec
2016

Lung transplantation is a complex medical treatment, and for patients with end-stage lung diseases it is often the last therapeutic option available for survival. However, lung transplantation poses not only a physical but also a psychological challenge for patients. The aim of this study was to gain a deeper understanding of patients' individual concerns related to their lung transplantation within the first 6 months post-transplant.

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Apr
2016

Several psychological sequelae have been identified in civilian war survivors. However, little is known about the prevalence of obsessive-compulsive symptoms and their relationship to trauma in this population.
Fifty-one adult civilian survivors of the Kosovo War (28 males) who had immigrated to Switzerland completed the Revised Obsessive-Compulsive Inventory Scale, the Posttraumatic Stress Diagnostic Scale and the Hopkins Symptom Checklist.

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Apr
2016

Trichotillomania (TTM) is characterized by recurrent hair-pulling behaviours that cause significant distress. Deficits in affective regulation have been reported in individuals with TTM. We aimed to investigate temporal stability of affective regulation in TTM individuals.

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Dec
1969

To (1) assess distinct clusters of psychological distress and health-related quality of life during the first 6 months following lung transplantation; (2) identify patients with poor psychosocial outcomes; and (3) determine potential predictors regarding psychological distress and health-related quality (HRQoL) of life at 6 months post-transplant.
A total of 40 patients were examined for psychological distress (Symptom Checklist short version-9) and quality of life (EuroQOL five-dimension health-related quality of life questionnaire) during their first 6 months post-transplant. Hierarchical cluster analyses were performed to identify specific types of post-transplant outcomes in terms of psychological distress and HRQoL over the first six post-transplant months.

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Feb
2016

Lung transplantation (LTx) aims to reduce physical disability and mental distress, extend survival, and improve health-related quality of life (HRQoL). In this systematic review we aimed to: (1) augment evidence regarding measures to assess HRQoL and psychological outcomes after LTx; and (2) summarize HRQoL and psychological outcomes after LTx.
Validated and standardized instruments with well-known psychometric properties used for assessing HRQoL and psychological outcomes after LTx were identified by means of comprehensive literature searches of PsychINFO and Medline/PubMed, up through March 2014, using the following search terms in various combinations: lung transplantation; physical functioning; symptom experience; mental health; anxiety; depression; distress; social functioning; life satisfaction; and health-related quality of life.

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Dec
1969

Trichotillomania (TTM) is characterized by recurrent hair-pulling that results in substantial hair loss. A previous pilot study demonstrated that the online self-help intervention 'decoupling' (DC) might be effective at reducing hair-pulling symptoms, with a stronger effect than progressive muscle relaxation (PMR). We aimed to extend these findings using a more robust randomized clinical trial design, including diagnostic interviews by phone, a 6-month follow-up and e-mail support.

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Dec
1969

The aim of the study was to determine if Sonoclot with its sensitive glass bead-activated, viscoelastic test can predict postoperative bleeding in patients undergoing cardiac surgery at predefined time points.
A prospective, observational clinical study.
A teaching hospital, single center.

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Dec
1969

The benefit of the post-anaesthesia care unit (PACU) with respect to an early detection of postoperative complications is beyond dispute. From a patient perspective, prevention and optimal management of pain, nausea and vomiting (PONV) are also of utmost importance. The aims of the study were therefore to prospectively measure pain and PONV on arrival to the PACU and before discharge and to determine the relationship of pain and PONV to the length of stay in the PACU.

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Dec
1969

Hippocampal volume is a promising biomarker to enhance the accuracy of the diagnosis of dementia due to Alzheimer's disease (AD). However, whereas hippocampal volume is well studied in patient samples from clinical trials, its value in clinical routine patient care is still rather unclear. The aim of the present study, therefore, was to evaluate fully automated atlas-based hippocampal volumetry for detection of AD in the setting of a secondary care expert memory clinic for outpatients.

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Apr
2015

The aim of this article is to examine the mutual associations between patients' and partners' depression and quality of life (QOL) in couples facing cancer with respect to potential resources (sense of coherence and relationship quality (RQ)) and stressors (physical complaints).
Questionnaires rating depression, QOL, sense of coherence, RQ, and physical complaints were completed by 207 couples facing different cancer types and stages. Multiple regression models were used to assess the mutual associations between patient and partner variables.

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Aug
2014

Previous research on trichotillomania (TTM) has demonstrated an emotion regulation function of hair pulling behavior. One condition that can impede the regulation of emotions is alexithymia. The present study aimed to explore the relationship between the degree of alexithymia and the severity of hair pulling behavior in individuals with TTM.

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Mar
2014

A rating scale for thirst and hunger was evaluated as a noninvasive, simple and commonly available tool to estimate preanesthetic gastric volume, a surrogate parameter for the risk of perioperative pulmonary aspiration, in healthy volunteer school age children.
Numeric scales with scores from 0 to 10 combined with smileys to rate thirst and hunger were analyzed and compared with residual gastric volumes as measured by magnetic resonance imaging and fasting times in three settings: before and for 2 h after drinking clear fluid (group A, 7 ml/kg), before and for 4 vs 6 h after a light breakfast followed by clear fluid (7 ml/kg) after 2 vs 4 h (crossover, group B), and before and for 1 h after drinking clear fluid (crossover, group C, 7 vs 3 ml/kg).
In 30 children aged 6.

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Dec
1969

While there is a considerable amount of literature addressing consequences of trauma in veterans and holocaust survivors, war and postwar civilian populations, particularly children, are still understudied. Evidence regarding intergenerational effects of trauma in families is inconsistent.
To shed light on intergenerational aspects of trauma-related mental health problems among families 11 years after the Kosovo war.

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Dec
1969

Concomitant skin conditions may be neglected in internal medicine patients due to lack of knowledge or resources. Thus, we investigated the prevalence of undiagnosed skin conditions in this population.
200 patients in a university medical center's internal medicine division were examined clinically for dermatoses and quality of life in a prospective, 2-month, single-center study.

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Jul
2012

Long term longitudinal data are scarce on epidemiological characteristics and patient outcomes in patients on maintenance dialysis, especially in Switzerland. We examined changes in epidemiology of patients undergoing renal replacement therapy by either hemodialysis or peritoneal dialysis over four decades.
Single center retrospective study including all patients which initiated dialysis treatment for ESRD between 1970 and 2008.

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Jun
2012

A transplant represents a decisive event for patients and their caregivers. This article deals with the attitudes patients and their spouses have towards the transplantation.
In a cross-sectional study, 121 patients and their spouses were surveyed by questionnaire after a heart, lung, liver or kidney transplant.

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Mar
2012

Medication non-adherence is a common problem in organ transplantation patients with severe consequences for the patients' health. This study aimed at examining the determinants of intention formation and adherence behavior based on the Theory of Planned Behavior (TPB). Moreover, to account for the role of patients' partners, provided social support by partners was included.

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Feb
2012

Cross-sectional gastric antral area (GAA) measurements by ultrasonography (US) have been proposed for preoperative assessment of gastric volume in adults but not been validated in children. This study investigates whether in children gastric volumes can be predicted by US performed in different patient positions.
Gastric fluid and air volumes were examined by magnetic resonance imaging before or up to 120 min after ingestion of 7 ml·kg(-1) diluted raspberry syrup in healthy volunteers who had fasted overnight.

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Jan
2011

The study is concerned with family physicians in the transition phase from residency to practice. Factors relating to the decision to take up a career in family medicine rather than a different medical career are investigated. Further, incentives and disincentives for starting a family practice as well as factors influencing the decision about practice location and practice model are addressed.

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Dec
1969

The communication with patients who have undergoned transplantation is greatly influenced by their subjective experience. This paper deals with this subjective transplant-specific experience six months after surgery.
Following their heart, lung, liver, or kidney transplantation, 120 patients were questioned concerning their experiences regarding the transplantation, the organ itself, and changes in their personal life.

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Oct
2010

To date, there are hardly any studies on the choice of career path in medical school graduates. The present study aimed to investigate what career paths can be identified in the course of postgraduate training of physicians; what factors have an influence on the choice of a career path; and in what way the career paths are correlated with career-related factors as well as with work-life balance aspirations.
The data reported originates from five questionnaire surveys of the prospective SwissMedCareer Study, beginning in 2001 (T1, last year of medical school).

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Feb
2011

The objectives of the study were to investigate the gender-related development of life satisfaction in young physicians over an 8-year period of residency, to compare it with a representative sample, and to analyze the relationships between both person- and health-related factors and life satisfaction.
A prospective study was carried out including five measurement points among a cohort of 337 Swiss physicians. Measurements include domain-specific life satisfaction (FLZ(M)), sense of coherence (SOC-13), anxiety and depression (HADS-D), chronic stress (TICS) and socio-demographic variables.

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Jul
2010

The present study aimed to compare the prevalence of work-life conflicts and the health status of physicians, with a representative sample of university graduates as well as with a representative sample of the general Swiss working population. Furthermore, it aimed to analyse whether work-life conflicts correlate with the health of physicians, as it does in the general working population.
The present cross-sectional study analysed data from 2007 originating from the SwissMedCareer Study (a prospective cohort study of physicians who graduated in 2001; n = 543) and the Swiss Household Panel (a representative Swiss survey on living and working conditions; university graduates of the same age range: n = 172, general working population of the same age range: n = 670).

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Sep
2010

Remembering painful incidents has important adaptive value but may also contribute to clinical symptoms of posttraumatic stress disorder and chronic pain states. Because glucocorticoids are known to impair memory retrieval processes, we investigated whether cortisol affects recall of previously experienced pain in healthy young men. In a double-blind, placebo-controlled crossover study, 20 male participants were presented pictures, half of them combined with a heat-pain stimulus.

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Jun
2010

In recent years, distress and alexithymia have been recognised as psychosocial factors related to both somatic and psychosomatic diseases. In this study distress and alexithymia and their associations with physical parameters were investigated in lung recipients.
The study, which included 76 patients after a lung transplant, measured psychological distress (Symptom Checklist, SCL-K-9) and alexithymia (Toronto Alexithymia Scale, TAS-20).

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Feb
2010

The profile of the medical profession is changing in regard to feminization, attitudes towards the profession, and the lifestyle aspirations of young physicians. The issues addressed in this study are the careers of female and male physicians seven years after graduation and the impact of parenthood on career development.
Data reported originates from the fifth assessment (T5) of the prospective SwissMedCareer Study, beginning in 2001 (T1).

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Feb
2010

Mortality of maintenance haemodialysis (HD) patients is very high due to polymorbidity, mostly from metabolic and cardiovascular disease. In order to identify patients with high risk for life-threatening complications, reliable prognostic markers would be helpful. Pregnancy-associated plasma protein-A (PAPP-A) has been shown to predict cardiovascular events and death in patients with stable coronary artery disease as well as in acute coronary syndrome in patients with normal renal function.

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Apr
2010

The objectives of the present study are to investigate and compare the relative impact of workplace-related factors and personal characteristics on chronic psychosocial stress experience in young physicians.
In a prospective study, a cohort of Swiss medical school graduates was followed up, beginning in 2001. In their fourth and eighth year after graduation, 443 physicians assessed their workplace conditions, the experienced effort-reward imbalance, the received professional and emotional support as well as their personal characteristics.

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Dec
1969

Chronic stress is a well-known consequence of somatic diseases. In this study, we investigated whether physical, sociodemographic, or transplant-related psychological factors were associated with the patient's chronic stress level. A cross-sectional study enrolling 76 patients measured chronic stress (Screening Scale, Screening Subscale of Chronic Stress of the Trier Inventory for the Assessment of Chronic Stress) and the emotional effects of the transplant (Transplant Effects Questionnaire), as well as physical and sociodemographic conditions (lung function, bronchiolitis obliterans syndrome, working status, and parenting).

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Jun
2009

Although one-lung ventilation (OLV) has become an established procedure during thoracic surgery, sparse data exist about inflammatory alterations in the deflated, reventilated lung. The aim of this study was to prospectively investigate the effect of OLV on the pulmonary inflammatory response and to assess possible immunomodulatory effects of the anesthetics propofol and sevoflurane.
Fifty-four adults undergoing thoracic surgery with OLV were randomly assigned to receive either anesthesia with intravenously applied propofol or the volatile anesthetic sevoflurane.

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Dec
1969

The study investigates the development of anxiety and depression during residents' postgraduate training as well as the symptom patterns and the prediction of these patterns of impaired affectivity by personality factors. It furthermore regards the differences between these patterns in workplace- and career-related factors as well as in worklife balance.
In a prospective cohort study (2001-2007), 390 junior physicians of various specialties (54.

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Nov
2009

Lung recipients undergo a complex psychological process, including organ integration and processing of attitudes towards the organ donor.
Seventy-six lung recipients were asked to participate in a cross-sectional questionnaire study on the psychological processing of lung transplants.
The questionnaire consisted of statements describing aspects of organ integration and the patient's relationship with the donor.

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Dec
1969

[Family and career planning in young physicians].

Gynakol Geburtshilfliche Rundsch 2008 3;48(4):234-40. Epub 2008 Dec 3.
Barbara Buddeberg-Fischer, Martina Stamm, Richard Klaghofer
The study investigates in what way physicians integrate their desire to have children into their career planning.
Within the framework of a prospective cohort study of Swiss medical school graduates on career development of young physicians, beginning in 2001, 534 participants (285 women, 249 men) were assessed in January 2007, in terms of having children, planning to have children, the career aspired to and the work-family balance used or planned.
Among the study participants, 19% (54) of the women and 24% (59) of the men have children.

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Sep
2008

Quality of life and psychosocial well-being usually improve after an organ transplant and remain stable for a minimum of several years. These findings, however, mainly apply to the "average" trend for transplant patients. This study aims to investigate whether transplant patients fall into different groups in good or poor psychosocial outcome after organ transplantation.

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Aug
2008

Various non-specific questionnaires were used to measure quality of life and psychological wellbeing of patients after organ transplantation. At present cross-organ studies dealing specifically with the psychological response to a transplanted organ are non-existent in German-speaking countries.
The Transplant Effects Questionnaire TxEQ-D and the SF-36 Quality of Life Questionnaire were used to examine the psychological response and quality of life of 370 patients after heart, lung, liver or kidney transplantation.

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Jun
2008

Within the framework of a prospective cohort study of Swiss medical school graduates, a Career-Success Scale (CSS) was constructed in a sample of young physicians choosing different career paths in medicine. Furthermore the influence of personality factors, the participants' personal situation, and career related factors on their career success was investigated.
406 residents were assessed in terms of career aspired to, and their career progress.

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May
2008

The present study aimed to investigate the differences between future family physicians, and physicians aspiring to other medical specialities, in terms of sociodemographic factors and variables concerning personality factors, career motivation, career success, importance of life goals and work-life balance; further, the stability in career choice of family physicians from medical school through to residency was evaluated.
Data reported are from four assessments of the Swiss physicians' longitudinal career development study, begun in 2001 (T1). At T4, in 2007, 543 residents (76% of the initial sample at T1) completed a questionnaire concerning their personal and professional goals.

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Dec
1969

The present study investigates a) whether the German version of the Transplant Effects Questionnaire (TxEQ-D), which measures the emotional response to an organ transplantation, has the same factorial structure as the English original version and b) whether the psychometric properties as well as the correlations with the scales of the SF-36 are comparable.
The questionnaire TxEQ was translated into German and filled out by 370 heart, lunge, liver and kidney transplant patients. Subsequently, factor and item analyses were conducted.

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Apr
2008

The aim of this study was to compare the following approaches to assess left ventricular preload by transesophageal echocardiography (TEE): left ventricular end-diastolic volume index (LVEDVI) determined by using the method of disc summation (LVEDVI(Md)) and left ventricular end-diastolic area index (LVEDAI) were compared with LVEDVI assessed by the modified Simpson formula (LVEDVI(Si)). Global end-diastolic volume index (GEDVI) and stroke volume index (SVI) measured by the PiCCO(plus) system (Pulsion Medical Systems, Munich, Germany) were used as TEE-independent reference variables.
Prospective observational study.

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Oct
2008

Job stress, investigated by the effort-reward model in various working environments in different countries, has been widely reported, yet studies addressing physicians are lacking. The present study investigated the perceived job stress, its association with the amount of working hours, and its impact on young physicians' self-reported health and their satisfaction with life during residency.
In a prospective study design, a cohort of Swiss medical school graduates was followed up, beginning in 2001.

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Mar
2007

Only few comparative prospective studies have been published on psychosocial issues of organ transplant. This study investigated patient groups with various organ transplants with respect to their quality of life and psychosocial situation before and after surgery.
76 patients receiving an organ transplant (lung n = 22, liver n = 26, allogeneic bone marrow n = 28) were investigated with regard to quality of life (SF-36), life satisfaction (FLZ), social support (F-SozU), and psychological symptoms (HADS-D) before (T0) as well as six (T1) and twelve (T2) months after transplant.

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Aug
2007

In vivo data for the kaolin-based ACT test from the Sonoclot Analyzer (SkACT, Sienco Inc, Arvada, CO) are lacking. The aim of this study was to compare SkACT with an established kaolin-based ACT from Hemochron (HkACT) and anti-Xa activity in patients undergoing cardiopulmonary bypass (CPB).
Prospective observational study.

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Jan
2007

The pretransplant medical evaluation of transplantation candidates includes an assessment of psychosocial data. This study investigates psychosocial vulnerability as a predictor of posttransplant outcome.
Seventy-six patients were assessed prior to lung, liver, or bone-marrow transplant.

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Dec
1969

Transplant patients are exposed to many different types of mental and social stress. The study investigates these patients' need for psychosocial counselling.
At 6 months and again at 12 months following either a lung, liver or bone-marrow transplantation, 76 patients were questioned about their need for psychosocial counselling.

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